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Year : 2022  |  Volume : 11  |  Issue : 3  |  Page : 201-207

Evaluation of the ex-vivo porcine simulator on EUS-guided cystogastrostomy using lumen-apposing metal stent training

1 Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Université Libre de Bruxelles, Brussels, Belgium; Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt
2 ROEYA Gastroenterology, Hepatology and Endoscopy Center, Cairo, Egypt
3 New Giza University, Cairo, Egypt
4 Department of Gastroenterology and Hepatology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
5 Department of Gastroenterology and Hepatology, King Fahad Medical City, Riyadh, Saudi Arabia
6 Department of Gastroenterology and Hepatology, Mansoura University, Egypt
7 Department of Gastroenterology, Alexandria Hospital, Egypt
8 Endemic Medicine Department, Helwan University, Egypt
9 Department of Endoscopy, Hospital of Ministry of Internal Affairs, Szczecin, Poland
10 Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore
11 Department of Gastroenterology, Juntendo University, Tokyo, Japan
12 Internal Medicine Department, Kasr Al-Ainy School of Medicine, Cairo University, Egypt
13 Department of Gastroenterology & Hepatology, Hospital Nord, Marseille, France
14 Department of Gastroenterology & Hepatology, Paoli Calmettes Institute, Marseille, France
15 Division of Gastroenterology, Department of Medicine, Siriraj Hospital, Bangkok, Thailand
16 Department of Hepato-Gastroenterology, Saint-Pierre Hospital, Brussels, Belgium
17 Division of Gastroenterology, Department of Medicine, Chulalongkom University, Bangkok, Thailand
18 Rajavithi Digestive Endoscopy Center, Bangkok, Thailand
19 Department of Endoscopy and Endoscopic Surgery, University of Tokyo, Tokyo, Japan

Correspondence Address:
Mostafa Ibrahim
Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Université Libre de Bruxelles, Brussels

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/EUS-D-21-00109

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Bckground and Objectives: EUS-guided cystogastrostomy is a well-established advanced endoscopic technique with a steep-learning curve which necessitates an ex-vivo simulator that would allow for adequate training. The aim of this study is to evaluate the feasibility of the model in allowing training for EUS-guided cystogastrostomy using lumen-apposing metal stent (LAMS). Subjects and Methods: The model was created by ROEYA Training Center, Egypt, using native porcine tissue to create fluid collections simulating both cystic and solid lesions. It was designed and tested in advance while the hydrogel was added on-site. The simulator was evaluated prospectively in five training sessions involving 17 international experts. The task was to successfully deploy the LAMS to drain the created cyst. After using the simulator, the experts were asked to fill a questionnaire to assess their experience. The primary endpoint was overall satisfaction with the model as a training tool. Results: All of the experts were satisfied with the model as a tool to train endoscopists for the technique. 76.5% (n = 11) of the experts thought the model to be moderately realistic. Proper visualization was reported by 94.1% of the experts. All experts believed the lesions to be either slightly like or very similar to real lesions. The model was graded “easy” in difficulty by 11 of the experts. Conclusions: In all parameters assessed, the experts thought the model to be a useful tool for future training. This preliminary study suggests that the aforementioned simulator can be used to train endoscopists on using LAMS in a risk-free environment.

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